Disabled Dependent Questionnaire

RI 30-10, Disabled Dependent Questionnaire

OMB: 3206-0179

IC ID: 33661

Information Collection (IC) Details

View Information Collection (IC)

Disabled Dependent Questionnaire
 
No Modified
 
Required to Obtain or Retain Benefits
 
5 CFR Chp 1 Sect 843.406 - 843.410  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction RI 30-10; Revised June 2010 Disabled Dependent Questionnaire RI30-010_2010_06_MarkUp.pdf Yes No Fillable Printable
Form and Instruction RI 30-10; Revised April 2016 Disabled Dependent Questionnaire RI30-010_2016_04_MarkUp.pdf Yes No Fillable Printable

General Government Executive Functions

OPM/Central-1  73 FR 15013

2,500 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,500 0 0 0 0 2,500
Annual IC Time Burden (Hours) 2,500 0 0 0 0 2,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
RI 30-10, Justification for Non-Material Change RI30-010_NonMaterial_Justification_2016.docx 03/31/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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